Randomized trial of exercise on cancer‐related blood biomarkers and survival in women with ovarian cancer

Author:

Cartmel Brenda12ORCID,Li Fang‐yong3,Zhou Yang12,Gottlieb Linda1,Lu Lingeng12,Mszar Reed1,Harrigan Maura1,Ligibel Jennifer A.4,Gogoi Radhika5,Schwartz Peter E.26,Risch Harvey A.12,Irwin Melinda L.12

Affiliation:

1. Department of Chronic Disease Epidemiology Yale School of Public Health New Haven Connecticut USA

2. Yale Cancer Center New Haven Connecticut USA

3. Department of Biostatistics Yale School of Public Health New Haven Connecticut USA

4. Department of Medical Oncology Dana‐Farber Cancer Institute Boston Massachusetts USA

5. Gynecologic Oncology, Women and Children's Institute Geisinger Health System Danville Pennsylvania USA

6. Section of Medical Oncology, Department of Internal Medicine Yale School of Medicine New Haven Connecticut USA

Abstract

AbstractBackgroundIn randomized trials in women with breast cancer, exercise has been shown to have beneficial effects on cancer‐related circulating biomarkers that may impact survival. Such studies are lacking for ovarian cancer.MethodsThis secondary analysis of a published randomized controlled trial examined the impact of a 6‐month exercise intervention versus attention‐control on change in prespecified circulating biomarkers (cancer antigen 125 (CA‐125), C‐reactive protein (CRP), insulin‐like growth factor‐1(IGF‐1), insulin and leptin) in a subset of participants who provided a fasting blood draw (N = 104/144) at enrollment and at 6 months. Change in biomarkers between study arms was compared using a linear mixed effects model analysis. An exploratory analysis of the exercise intervention versus attention‐control on all‐cause mortality included all (N = 144) participants. All statistical tests were two‐sided.ResultsParticipants included in the biomarker analysis were 57.0 ± 8.8 (mean ± SD) years old and 1.6 ± 0.9 years post‐diagnosis. Adherence to the exercise intervention was 176.4 ± 63.5 min/week. Post intervention IGF‐1 (group difference in change: −14.2 (−26.1 to −2.3) ng/mL (least squared means (95% CI))) and leptin (−8.9 (−16.5 to −1.4) ng/mL) were significantly reduced in the exercise group (N = 53) compared to those in attention‐control (N = 51). No group difference in change was seen for CA‐125 (p = 0.54), CRP (p = 0.95), or insulin (p = 0.37). With median follow‐up of 70 months [range 6.6–105.4 months], 50/144 (34.7%) (exercise group; 24/74 (32.4%) versus attention‐control group; 26/70 (37.1%)) participants died with no between group difference in overall survival (p = 0.99).ConclusionsFurther studies are needed to determine the clinical significance of exercise‐induced changes in cancer‐related circulating biomarkers in women with ovarian cancer.

Funder

National Cancer Institute

National Center for Advancing Translational Sciences

Publisher

Wiley

Subject

Cancer Research,Radiology, Nuclear Medicine and imaging,Oncology

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